Pelvic Exam

What is a pelvic exam?

A pelvic exam is a checkup of your vagina (birth canal), uterus (womb), ovaries, and fallopian tubes. The check of the uterus includes the cervix, which is the opening of the uterus into the vagina. The uterus is the muscular organ at the top of the vagina. Babies develop in the uterus and pass through the vagina during the birth process. Menstrual blood forms in the uterus each month and flows through and from the vagina during your period. The exam will vary depending on your needs, but it will usually include a Pap test.

Having this exam may be stressful for many women. This is easy to understand since the area being examined is considered private and the exam can be uncomfortable. Your healthcare provider is aware of this discomfort and will help you through it.

Why should I have a pelvic exam?

A pelvic exam is an important part of taking good care of your health. It helps your healthcare provider find or diagnose problems with your female organs. It may be used to check for:

• normal development of the female organs
• irritation or infection, including sexually transmitted diseases
• abnormal changes in the cells of the cervix, including cancerous or precancerous cells
• growths in the uterus, such as fibroids
• tubal pregnancy
• ovarian cysts (fluid-filled sacs in or on an ovary)
• hormone levels.

When should I have a pelvic exam?

You should start having regular pelvic exams when you become sexually active or by the age of 21, whichever happens first. You may also need a pelvic exam if you are having problems, such as, your periods have not started and you are 16 years old or older or you are having unusual or heavy vaginal bleeding or discharge.

Pap tests are often a part of a pelvic exam. After your first pelvic exam and Pap test, you should have a Pap test at least every 3 years if you have ever had sex and have not had your uterus removed. Your healthcare provider will tell you how often you need to have a Pap test and pelvic exam.

Schedule the exam when you will not be having your period.

How do I prepare for a pelvic exam?

• Do not douche or use vaginal creams or ointments for 2 days before the exam.
• Do not have sexual intercourse within 24 hours of the appointment because it can cause inaccurate test results.
• Be ready to talk openly and honestly with your provider about any questions or concerns you or your provider may have. Your discussion will be very confidential.

What happens during the exam?

If this is your first exam, the office staff and provider will be able to explain the procedure before you have the exam. Knowing what will happen ahead of time will help you be less anxious about it. If you have a male healthcare provider, a female nurse will usually be in the room during the exam.

If you have any special concerns or questions, it is best to let your provider know before the exam, in case special attention needs to be given to any particular area.

Just before the exam, you will be asked to empty your bladder. You will take off your clothes and put on a gown. A cloth will be draped over the lower part of your body. You will lie on your back on the exam table with your knees bent and your feet on foot rests, or stirrups. You will be asked to slide your hips to the end of the table and let your legs fall to each side so that your legs are spread apart.

The pelvic exam takes only a few minutes. Your provider will check the skin and glands on the outside opening of the vagina and look for any swelling, sores, or warts. Then he or she will insert a speculum gently into the vagina to hold the vaginal walls open. A speculum is a thin, lubricated plastic or metal instrument shaped like the bill of a duck. It opens the vagina just enough to allow your provider to look at the surface of the vagina and cervix and check for irritation, infection, or growths. You should try to stay relaxed and to breathe slowly and deeply. This will help keep your abdominal muscles relaxed and make it easier for your provider to do the exam. You may feel a pulling sensation during the exam.

Your provider will use a brush to collect cells from your cervix at the top of the vagina. This is called a Pap test. The cells will be examined in the lab. A sample of vaginal discharge may also be tested in the lab. After the samples are taken your provider will remove the speculum.

Your provider will then put 1 or 2 lubricated, gloved fingers in your vagina and a hand on your abdomen to feel and check the uterus, fallopian tubes and ovaries. This is done to feel their size and shape and to make sure they are normal. It may cause a slight discomfort, but it is usually not painful.

If you are over 50, your provider may also put a finger in your rectum to check for lumps that might be cancerous.

What happens after the exam?

Your healthcare provider will review the results of the exam and may ask questions about sex, menstrual periods, birth control, or hormone problems that are related to the results of your exam. Most women should have a well woman's physical exam every year, even if they are one of those who do not need a Pap test every year. Doing this will help ensure that changes are found as early as possible.

What are the benefits of the exam?

The pelvic exam and Pap test may find problems that can be treated early to prevent complications, so you can stay healthy.